…on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained in the previous…

…and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of…

…result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words…

…Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and/or low arterial oxygen saturation Syncope These findings may occur singly or in combination…

…except in type 2 and type 3 MI. A diagnosis of MI should not be made solely from an abnormal cTn concentration in the absence…

…sex and age, to identify deviations from normal values. This enhances the ability to detect subtle perfusion defects and differentiate between normal and abnormal patterns…

…This is also a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding…

…the sinoatrial node) is a common finding in athletes and during sleep; in these scenarios, it should not be considered abnormal. On the other hand…

…than in HFpEF. The clinical population is heterogeneous because the HFmrEF range includes both patients with recovering systolic function and those with deterioration from a…

…gradually from V1 to V5 and then diminishes again in V6. Refer to Figure 1 . Abnormal R wave progression implies that the gradual increase from…

…transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural ischaemia. The resulting abnormalities in…

…appendage and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other organs. However, the increased risk in mortality…

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

…Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite familial hypercholesterolaemia Other markedly abnormal single risk factors or genetic…

…GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur…

…represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of a coronary artery from the…

…response. The ECG in ectopic atrial rhythm and atrial tachycardia A regular rhythm with P waves that differ in contour from sinus P waves. If…

…and jugular venous distention. Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia, tachypnea, weakened peripheral pulses, edema, cyanosis. Cardiac tamponade is seen in…

…as an abnormal and wide QRS complex occurring earlier than expected in the cardiac cycle. It is caused by an impulse discharged from an ectopic…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The…

…or abnormal arteriolar vasoconstriction. More than one mechanism may coexist. Supply–demand mismatch MINOCA may result from a mismatch between myocardial oxygen supply and demand…

…bundle of His, and hence it originates in the atria. In other words: tachycardias with narrow QRS complexes originate in the atria. the term supraventricular…

…upper reference limit is considered elevated (abnormal) and thus indicates myocardial necrosis. The upper reference limit is currently the 99th percentile in a healthy population…

…acute pain or other stimuli that increases vagal tone. In all other situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses…

…ventricular rhythm and idioventricular rhythm The usual mechanisms are responsible for all ventricular rhythms. Increased automaticity (in His Purkinje fibers), abnormal automaticity (in contractile myocardium…

…The differences increase in severe circulatory failure and marked respiratory failure [3,4]. Question Appropriate sample : : Metabolic acidosis or alkalosis in a haemodynamically stable patient…

…however, and an abnormal result is not specific to delirium. Symptoms are often worse in the evening and at night, but diurnal variation is not…

…transition from ST segment to T wave is smooth, and not abrupt. ST segment deviation (elevation, depression) is measured as the height difference (in millimeters…

…abnormal. A common cause of abnormally large T waves is hyperkalemia, which results in high, pointed and asymmetric T waves. These must be differentiated from…

…may arise from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial injury may be seen in heart failure, cardiomyopathies, and severe valvular…

…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

…network), which results in rapid impulse transmission and thus shorter QRS duration (as compared with apical pacing). Because ventricular pacing results in abnormal depolarization, repolarization…

…emerge due to increased/abnormal automaticity, re entry or triggered activity. All types of myocardial cells may be engaged in initiation and maintenance of this…

…used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores…

…in V5. The third vector: the ventricular free wall The vectors resulting from activation of the ventricular free walls is directed to the left and…

…owing to changes in intra and extracellular electrolyte concentrations. Some electrolyte imbalances are clinically negligible (from an electrophysiological standpoint), whereas others may be life threatening…

…one in five strokes. Thrombus formation is most commonly related to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small…

…sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent hypercapnic respiratory acidosis, if invasive…

…precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for the prevention…

…study, while variants of uncertain significance were found in a further 44%. Truncating variants in TTN are among the most frequent recognised genetic findings and

…lipoproteins in addition to LDL and other apoB containing particles. Cardiovascular risk categories Primary prevention For adults aged 40–75 years without diabetes and with…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG…

…spot, in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The…

…80 mg tablet once daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…Their clinical importance arises from the causal role of low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD…

…effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to…

…or other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral…

…in the chest and may extend to the arms, shoulders, neck, jaw, upper back, abdomen, or epigastrium. Dyspnoea, nausea, vomiting, diaphoresis, fatigue, faintness, and other…

…1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…rales, or respiratory distress. In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non…

…particularly in complex multivessel or left main disease. Clinical presentation and symptoms The clinical presentation of multivessel CAD varies from stable angina or exertional limitation…

…sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2:1 block will be difficult…

…strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In…

…constantly in a struggle with factors striving to lysate the thrombus (pro thrombolytic factors). The balance between pro thrombogenic and pro thrombolytic factors varies from…